Summary/Conclusion
Pulsed irradiation (FLASH) was performed using the 4.5 MeV linear electron accelerator (LINAC) described in (34). The system allows exposure of cells or animals to a single submicrosecond pulse, to any sequence of pulses, or to split-dose irradiation with an interval between fractions ranging from fractions of seconds to a few minutes.
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The preoperative diagnostic work-up must be comprehensive and the selection process must be rigorous for this therapeutic approach reserved for small ductal unifocal cancers. After 23.3 months median follow-up, the clinical results of IOERT for selected patients are encouraging for locoregional recurrence rate and toxicity rates. The satisfaction of our patients in terms of quality of life was extremely high.
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The combination of pre-operative radiation, surgical resection, and intraoperative radiation produce excellent local disease control for RPS.
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The outcomes for patients receiving IOERT in the setting of local recurrence compare favorably to similar cohorts treated by local resection alone suggesting the potential for improved DFS with IORT.
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Although the rate of IBTR was within pre-specified equivalence margin, the rate was significantly greater than with EBRT, and overall survival did not differ between the groups. Improved selection of patients should reduce the rate of IBTR with IOERT.
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